| NPI | 1033432091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 050338) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps50416) |
| Enumeration Date | 2010-03-04 |
| Last Update Date | 2015-06-19 |